Seeing double: the low-carb diet

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Comparing face-to-face with online training for occupational therapists in advising on fitness for work: Protocol for the CREATE study

© The Author(s) 2020. Introduction: Occupational therapists play a key role in advising on fitness for work; however, there is a concern that they lack knowledge and confidence in using the Allied Health Professions health and work report (formerly the Allied Health Professions advisory fitness for work report), developed in the United Kingdom. Comparing a reusable learning object with face-to-face training for occupational therapists in advising on fitness for work (CREATE) compares face-to-face training with online training for occupational therapists in completing the Allied Health Professions health and work report. Method: A mixed methods study. Phase 1, occupational therapists will co-design an online training resource. A standardised face-to-face group-based training session will also be developed based on the same content. Phase 2, a feasibility study will be conducted. Thirty occupational therapists will either attend face-to-face group training or access the online resource. Data on self-reported knowledge and confidence in using the Allied Health Professions health and work report will be collected at baseline, 1 week and 8 weeks post-training. Feedback on the training will be collected by interview and, for the online resource, using an online tool. Results: Quantitative results will be predominantly analysed descriptively. If appropriate, between-group responses will be compared using the Mann–Whitney test. Qualitative findings will be analysed thematically. Conclusion: CREATE will have made a significant contribution to the debate around appropriate training methods in advising on fitness for work

The Nottingham Fatigue After Stroke (NotFAST) Study: results from follow-up six months after stroke

Background: Post-stroke fatigue is common and disabling. Objectives: The aim of NotFAST was to examine factors associated with fatigue in stroke 3 survivors without depression, six months after stroke. Methods: Participants were recruited from four UK stroke units. Those with high levels of 5 depressive symptoms (score ≥7 on Brief Assessment Schedule Depression Cards) or aphasia were excluded. Follow-up assessment was conducted at six months after stroke. They were assessed on the Fatigue Severity Scale, Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Barthel Index, Beck Anxiety Index, Brief Assessment Schedule Depression Cards, Impact of Event Scale-Revised, and Sleep Hygiene Index. Results: Of the 371 participants recruited, 263 (71%) were contacted at six months after stroke and 213 (57%) returned questionnaires. Approximately half (n=109, 51%) reported fatigue at six months. Of those reporting fatigue initially (n=88), 61 (69%) continued to report fatigue. ‘De novo’ (new) fatigue was reported by 48 (38%) of those not fatigued initially. Lower Nottingham Extended Activities of Daily Living scores and higher Beck Anxiety Index scores were independently associated with fatigue at six months. Conclusions: Half the stroke survivors reported fatigue at six months post-stroke. Reduced independence in activities of daily living and higher anxiety levels were associated with the level of fatigue. Persistent and delayed onset fatigue may affect independence and participation in rehabilitation, and these findings should be used to inform the development of appropriate interventions

Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of the SPORTSMART pilot randomised controlled trial

Background: The objective of this study was to compare the costs and outcomes of two sexually transmitted infection (STI) screening interventions targeted at men in football club settings in England, including screening promoted by team captains. Methods: A comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms: (1) captain-led and poster STI screening promotion; (2) sexual health advisor-led and poster STI screening promotion and (3) poster-only STI screening promotion (control/comparator). For all study arms, resource use and cost data were collected prospectively. Results: There was considerable variation in uptake rates between clubs, but results were broadly comparable across study arms with 50% of men accepting the screening offer in the captain-led arm, 67% in the sexual health advisor-led arm and 61% in the poster-only control arm. The overall costs associated with the intervention arms were similar. The average cost per player tested was comparable, with the average cost per player tested for the captain-led promotion estimated to be £88.99 compared with £88.33 for the sexual health advisor-led promotion and £81.87 for the poster-only (control) arm. Conclusions: Costs and outcomes were similar across intervention arms. The target sample size was not achieved, and we found a greater than anticipated variability between clubs in the acceptability of screening, which limited our ability to estimate acceptability for intervention arms. Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated

Yangian in the Twistor String

We study symmetries of the quantized open twistor string. In addition to global PSL(4|4) symmetry, we find non-local conserved currents. The associated non-local charges lead to Ward identities which show that these charges annihilate the string gluon tree amplitudes, and have the same form as symmetries of amplitudes in N=4 super conformal Yang Mills theory. We describe how states of the open twistor string form a realization of the PSL(4|4) Yangian superalgebra.Comment: 37 pages, 4 figure

Strength based nursing: caring for the whole person

Strengths-Based Nursing (SBN) is an integrated value-driven approach based on a philosophy of care to guide actions. It consists of eight values which guide nursing practice to promote care of the whole person and family.  SBN promotes empowerment, collaborative partnership, innate health and healing, authentic relationships while focusing on enhancing and developing strengths to cope with challenges and minimize, contain or circumvent that which is not working.Our poster will illustrate the basics of SBN and how it can be utilized in the promotion of whole person care.Conclusion: SBN has enlarged our perspective, broadened our skilled-know how, and opened us to new ways of caring for persons and families dealing with cancer. It has also given us insights into our nursing practices and illustrates the importance these eight values have in supporting development of whole person care

Investigating the barriers and facilitators to implementing Mental Health First Aid in the workplace: a qualitative study

Purpose: There has been little research into the use and efficacy of Mental Health First Aid across UK workplaces. The present study investigated the implementation of MHFA across six UK organisations, identifying key barriers and facilitators.Design: Twenty-seven workplace representatives were recruited from six organisations through purposive sampling and took part in semi-structured interviews exploring their experiences of workplace MHFA. The data underwent thematic analysis, identifyingkey themes around implementation.Findings: Implementation varied across organisations, including different reasons for initial interest in the programme, and variable ways that MHFA-trained employees operated post-training. Key barriers to successful implementation included negative attitudes around mental health, the perception that MHFA roles were onerous, and employees’ reluctance to engage in the MHFA programme. Successful implementation was perceived to be based on individual qualities of MHFA instructors and good practice demonstrated by trained individuals in the workplace. The role of the innerorganisational setting and employee characteristics were further highlighted as barriers and facilitators to effective implementation.Research implications: MHFA is a complex intervention, presenting in different ways when implemented into complex workplace settings. As such, traditional evaluation methods may not be appropriate for gaining insights into its effectiveness. Future evaluations of workplace MHFA must consider the complexity of implementing andoperationalising this intervention in the workplace.Originality: This study is the first to highlight the factors affecting successful implementation of MHFA across a range of UK workplaces

Complete Equivalence Between Gluon Tree Amplitudes in Twistor String Theory and in Gauge Theory

The gluon tree amplitudes of open twistor string theory, defined as contour integrals over the ACCK link variables, are shown to satisfy the BCFW relations, thus confirming that they coincide with the corresponding amplitudes in gauge field theory. In this approach, the integration contours are specified as encircling the zeros of certain constraint functions that force the appropriate relation between the link variables and the twistor string world-sheet variables. To do this, methods for calculating the tree amplitudes using link variables are developed further including diagrammatic methods for organizing and performing the calculations.Comment: 38 page